Older Adults/ Seniors and Technology Stereotype (Research, Video 2:58)

What percentage of adults over age 65 use the Internet? If you’re like most people, you may have bought into the stereotype that the percentage is very low. Actually, 42% of adults over age 65 use the Internet. This statistic has increased 11% over the past year and continues to grow.

What are they doing on the Internet? Young people might say they are looking for sales on walkers or Viagra sources. They could be right, but older adults are looking for so much more and finding it. I personally know an older adult who has found love on the Internet twice at a matchmaking website. Researchers at the Georgia Institute of Technology report that older adults’ positive attitudes about technology outnumber their negative attitudes. They believe that positive attitudes support many activities that older adults find convenient and useful.

Is there anything older adults don’t like about the Internet? Like many of all ages, they worry about Internet security. With all the hacking and scamming that target older adults, they should be concerned. They dislike some of the inconvenience and unreliability that holds hands with technology sometimes. But they mostly like the benefits they get from the technology experience such as Internet browsing, learning new information, social networking with family and friends, and even planning trips on their own.

Put the technology stereotype to rest. There’s a big world out there in cyberspace. Education can encourage even more older adults to explore the many wonders technology has to offer. If you're a senior who wants to learn more about traveling in cyberspace, contact your local Area Agency on Aging, a senior center, or your public library for information on where you can attend classes. Have a great trip!

At the age of 91, Naomi Long Madgett, Poet Laureate of Detroit, MI, enjoys using technology. Her good choices with the "new stuff" enhance her quality of life. You can read more about Naomi and iPad research with older adults here:

https://www.linkedin.com/pulse/selfie-detroit-poet-laureate-techie-91-ipad-research-parker?trk=mp-reader-card

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Hospice and Nursing Homes Blog

Hospice Volunteers and Family Bereavement (Research, Video 5:41)

Even after patients have died, the impact of hospice volunteers continues. Volunteers can play an important role in the bereavement of family members and the ratings of their loved ones’ quality end-of-life care. A study at the Warren Alpert School of Medicine at Brown University highlights the importance of volunteers in bereaved family members’ higher overall satisfaction with hospice services.

Using an analysis of the number of volunteer hours used in direct patient care and the total number of patient days served, researchers surveyed 305 hospice programs (67% freestanding and 20.7% for profit). A total of 57,353 surveys were submitted. Hospice programs with the greatest usage of volunteers had higher overall ratings of quality care. These programs with higher use of volunteers per patient day were associated with bereaved family members’ reports that the hospice programs quality of care was excellent. Research results such as this confirm the major contributions hospice volunteers make in improving quality end-of-life-care and bereavement.

This video showcases The Community Hospice, the largest hospice program in New York and one of the nation’s largest non-profit hospice programs. Grief and bereavement programs there service everyone, regardless of whether the person who died was a hospice patient:

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog

Older Adult/ Senior Bullies in Long-Term Care and Senior Communities

Some people wake up and change. Others just roll over. I’m referring to the bullies of our pasts and others who have become older adult bullies. These bullies are now terrorizing residents in long-term care and assisted living facilities, senior centers, and retirement communities around the country.

Welcome to the irony of older adults practicing ageism. The first time I witnessed older adults bullying others was at a senior center where, after a great deal of resistance from members, the age for joining the center had finally been lowered from 62 to 55 years old. Most local senior centers had already lowered their membership age years before this center. Several older members were openly rude to younger members who joined. At lunchtime, I watched them “reserving” tables for their older friends and leaving leftover seating for younger members. I overheard negative comments about “those new young people” stated loudly enough for everyone to hear. I even witnessed an attempt to get a younger member in trouble. I reported all incidents I witnessed to the administration. They said they were “working on the problem, but change takes time.” Unfortunately, many older adults don’t have a lot of time ahead of them. No one should have to spend their golden years being victimized daily by mean-spirited bullies.

These are some hurtful actions of “mature” bullies:

1.    Block off seats for their little cliques at mealtimes and events.

2.    Criticize, ridicule, and lie about those who don’t meet their standards of acceptance regarding race, ethnicity, sexual orientation, religion, economic background, and any other criteria they condone.

3.    Steal and destroy property to flaunt their power and harass victims.

4.    Physically abuse victims by pushing, hitting, punching, or kicking them. They sometimes justify this as an “accident.”

A former school principal, I know bullying is a problem that only gets worse when it’s ignored. Too often the victims are vulnerable and defenseless. Some, such as those targeted because of their sexual orientation, become so depressed they commit suicide. Observers are often too afraid themselves to take a stand. The administration must be seriously involved. These are some guidelines that can help solve problems of bullying:

1.    Commit to and promote principles of equality and respect for all residents/members.

2.    Do a confidential needs assessment on bullying to determine how severe the problem is. General needs assessments should be done annually.

3.    Have open discussions involving residents, staff, and community members about bullying, its causes, and solutions. Consultants with expertise in bullying, conflict resolution, diversity, etc. can be especially helpful.

4.    Provide extensive staff training in how to handle bullying among themselves and those they serve.  Continue to educate residents/members. Victims need the support, and bullies need to be reminded that eliminating bullying is an ongoing priority.

5.    Review and change procedures that can decrease the power of bullies. For example, eliminating reserved seating and implementing another seating procedure can prevent bullying cliques from saving blocks of the best seats for themselves.

6.    Create and disseminate a zero tolerance policy on bullying along with channels for reporting incidents and resolving them.

7.    Keep in mind that the goal is to create a culture where no bullying is the standard embedded in how the institution operates. There must be consistency in implementation and visible recognition of everyone’s dignity and rights.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

Animals Supporting Hospice-Palliative Care Philosophy (Research, Video 4:15)

Many animals seem to instinctively support the hospice-palliative care philosophy. Researchers at the University of Stirling and at Blair Drummond Safari Park in the United Kingdom reported how three chimpanzees nurtured an elderly dying chimpanzee named Pansy. Although the chimpanzees had been separated from Pansy during the earlier stage of her illness when she was being treated, they were allowed to join her during the final phase just before her death. The chimpanzees “frequently groomed and caressed” her. They stayed close to her, shook her shoulder to test for signs of life, and appeared to understand when she was no longer alive. Although Pansy’s daughter Rosie did not normally sleep near her mother, she stayed with her mother’s corpse most of the night, but she didn’t sleep soundly.

Sixteen hours later, the chimpanzees quietly witnessed Pansy’s corpse being removed by the zookeepers. Days later, they were still subdued and refused to make a nest on the platform where Pansy had died. I thought it was interesting that they also demonstrated a need for more attention for themselves. For humans, the bereavement process is so often made easier when others support their healing.

Should zookeepers re-evaluate the common practice of removing terminally ill animals from a group?  James Anderson, lead author, thinks so. He says, “It may be more humane to allow the group to remain together until a sick animal dies, to give the ailing animal comfort, and allow the group a sense of closure.” Does that sound familiar?

The video below highlights an everyday cat coping with the suffering or death of another cat. It’s raw expression of nurturing and grief. This scenario says a lot about animals and heartfelt caregiving. Can you feel the love?

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Poem About Loneliness in Older Adults/ Seniors

                                         
She waited, grasping like a New Year's resolution...

Festive holidays have brought cherished opportunities for many older adults to enjoy some visitors they seldom see during most of the year. Whether at home or in institutions, loneliness can be both difficult and dangerous for their overall health. Too many of them endure the negative impact of loneliness daily.

“Missing” is one of sixteen original poems at the end of each chapter in Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. A hospice volunteer, I wrote it after witnessing the sadness of lonely nursing home residents who were missing the missing. They coped with ongoing loneliness that could easily have been avoided with gifts of time. But some relatives and friends kept putting off visiting them until it was too late.

As this new year begins with resolutions for change, consider making every effort to visit those who are ill or alone. Don’t sentence them to another year of missing you.

Missing

She waited,

hoping her years of caring

endured in grown-up minds,

rested in distant hearts,

conveyed how much she missed them.

She waited,

living real-time movies

of restless nights, anxious days

with inhaled hopes of fellowship,

exhaled sighs of deep despair.

She waited,

wishing nostalgic winds

flowed through cotton curtains,

brought relatives and friends

she cherished through the years.

She waited,

grasping like a New Year's resolution,

like a second suspended in time

until her clock stopped ticking

for visitors who never came.

© Frances Shani Parker

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog

Hospice-Palliative Care Diversity Outreach: Asian Culture (Chinese American Video 1:32)

Meeting the cultural needs and preferences (ethnic and religious beliefs, values, and practices) of hospice-palliative care patients is an important part of quality health care. People view the world through their cultures and values. To ignore this fact and impose one’s own culture and values on others caters to miscommunication and alienation. With respect and sensitivity, bridges can be built that help people connect at human levels, regardless of their differences. The availability of more language interpreters at healthcare institutions can facilitate this communication and bonding. Ongoing education on the culture and traditions of various populations, along with the understanding that varied beliefs exist within each group, must be increased throughout the healthcare system to improve service to diverse groups.

Many Asians prefer family caregiving of their aging, terminally ill relatives. In addition to being reluctant to place their elders in nursing homes for hospice care, they may also be reluctant to discuss specifics about illnesses with those in their care to keep them hopeful and without worry. Some Asian cultures consider direct eye contact, particularly with someone considered a superior to be inappropriate. Healthcare providers should gather more knowledge of Asian culture, including input from Asians, in order to promote benefits of hospice and palliative care.

In the following video, Nellie Kwan, a hospice clinical supervisor who works for Self-Help Hospice in San Francisco, describes cultural concerns regarding end-of-life care and Chinese Americans. According to her, most Chinese Americans do not understand hospice at all. This video is part of the Hospice Foundation of America “HFA Cares” series:

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Healthcare Workers: Choirs Sing Holiday Music (Research, Video 3:56)

Happy Holidays From Frances Shani Parker

Years ago when I was a teacher, several co-workers decided to organize a staff choir. The announcement circulated quickly, and, to my great joy, anybody, even average shower singers like I was, could join. We met after school each week and slowly became acquainted with more layers of ourselves than my grandma’s lasagna. It was magical how music could so easily remove everyday distractions of the world.

Because music is so universal, I thought about this when I read research about healthcare workers of the Staff Christmas Choir of the Peter MacCallum Cancer Centre ("Peter Mac") in Australia. Peter Mac is a world leader in cancer treatment, research, and education. I wondered if their choir had teased one another like we had, joked about the challenges of harmonizing, and if they generally had a great time just singing. Most of all, I wondered if they were swept into the magnificence of inspiring and healing themselves and others through song.

Research indicates they definitely accomplished the latter. Seven performances were given at Centre locations which included inpatient wards, outpatient waiting areas, and a cafeteria. In order to evaluate performances, oncology inpatients, outpatients, and visitors were given anonymous, semi-structured questionnaires during and after performances. Of the 111 responses, including some from people with Jewish, Hindu, and atheist backgrounds, 93.7 % were favorable. Several people described “transformative thoughts and physical reactions, felt affirmed by the Christmas spirit or message, and/or appreciated the peaceful or enlivened and social atmosphere.” The importance of "enjoying the moment" was also a recognized benefit.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Hospice and Nursing Homes Blog

The Long and Short of Hospice Time in Nursing Homes (Research)

As a hospice volunteer in Detroit nursing homes, I have had hospice patients stay as short as one day and as long as three years. With little quiet or privacy, almost all of them shared rooms with one to three non-hospice residents. My three-year patient was 94 years old. Having few visits from relatives and friends who lived out of town, her biggest fear was the possibility of being released from hospice care and the nursing home. I’ve also had rare happy patients who were released from hospice because their health improved.

One patient with dementia seemed to have a premonition that she would be leaving soon when she said to me one day, “I was wondering if you could help me find another apartment. I’ve been thinking about looking for a new place to stay, maybe a place closer to where I used to live. This apartment building is too noisy. Just close your eyes and listen to all the talking, buzzers, and everything. People come into my place without even knocking. They just walk right in and go through my closet and drawers. It’s not right. Three ladies even moved in with me when I wasn’t looking. Now, I can’t get them out.” I had never heard her say anything about leaving before. Two weeks later, she was released from hospice care and moved to a nursing home near her son’s house.

Are there characteristics of nursing homes and residents that are associated with long and short hospice stays? Using 13,479 residents enrolled in hospice care, researchers at Harvard Medical School looked for answers to this question. Research results indicated the following:

1)    Nursing home characteristics were not statistically significant predictors of long stays.

2)    The probability of a short stay increased with the facility's nurse staffing ratio and decreased with the share of residents covered by Medicaid.

3)    Men (relative to women) and blacks (relative to whites) were less likely to have a long stay and more likely to have a short stay.

4)    Those 70 years or younger (relative to those 81-90) and residents with Alzheimer's disease/dementia were more likely to have long stays and less likely to have short stays.

5)    Fourteen percent of hospice users were discharged before death because they failed to meet Medicare hospice eligibility criteria. These residents on average had longer lengths of stays.

If you work with hospice patients in nursing homes, have you noticed these occurrences? Researchers concluded “high rates of discharge before death that may reflect a less predictable life trajectory of nursing home residents suggests that further evaluation of the hospice benefit for nursing home residents may be needed.”

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Eldercare Robot: CareBot Companion and Caregiver for Older Adults (Video 2:19)

We can pretend that robots are only for sci-fi movies, but they are already being created to make life easier for older adults. Artificial intelligence of robots makes them especially good companions for older adults living alone or those in need of caregiving attention. What is artificial intelligence? This means the robot not only has the ability to navigate safely in its surroundings, but it also has the intelligence to do meaningful caregiving.  Maybe that’s why they are called CareBots.

The GeckoSystems CareBot is a robotic eldercare system that allows family members to care for older adults from afar. According to Martin Spencer, President/CEO of GeckoSystems, CareBot is a new kind of companion that “always stays close to the care receiver, enabling family and friends to care for them from afar. It tells them jokes, retells family anecdotes, reminds them to take medication, reminds them that family is coming over soon (or not at all), recites Bible verses, plays favorite songs and/or other music.” Even the voice can be customized.

From a security point of view, a CareBot alerts family members when unexpected visitors or intruders are present. It notifies designated caregivers when a potentially harmful event has occurred such as a fall, fire in the home, or even if no one has been present for too long. It responds to calls for help and notifies those persons that the caregiver has designated.

Referred to as Emily, the CareBot in this video serves as a helpful companion to Doris by keeping track of her taking medicines, reminding her about TV shows, and performing other tasks that improve the quality of Doris’ life.

What do you think about having Emily or another CareBot living with you or helping an older adult in your family?

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Hospice and Nursing Homes Blog

Palliative Care Professionals Change Through Shared Stories (Research, Hospice Video 2:16)

Never underestimate secondhand life experiences. I know how someone else’s story can grab me by the collar, drag me into a clear day on a stormy night. When writing for others, I have wandered through high weeds of words, while seeking a path of truth behind the noise of my thoughts. True stories sometimes come drenched in life-changing powers. I wish more people would tell and listen to stories the way children do with wide-eyed openness for learning. That’s why I am pleased to report this research about palliative care professionals telling true stories about their work.

Reported in the “Journal of Interprofessional Care,” this research consisted of a series of six interprofessional palliative care meetings held in facilitated small groups. The 28 participants, which included doctors, nurses, social workers, and emergency care practitioners shared stories about their professional experiences. Evaluations of the meetings were done via telephone interviews with 19 of the participants reporting. Findings resulting from their shared discussions included this statement:

“Five months after the end of the course, many participants described changed professional behavior which they believed led to improved patient outcomes.”

Now, that was some great storytelling!

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Engage With Grace: Discuss End-of-Life Wishes During Holidays

For three years running now, many of us bloggers have participated in what we call a “blog rally” to promote Engage With Grace, a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes. The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family.

At the heart of Engage With Grace are five questions designed to get conversations about end-of-life started. We’ve included them at the end of this post. They’re not easy questions, but they are important. Believe it or not, most people find they actually enjoy discussing their answers with loved ones. The key is having these conversations before it’s too late.

This past year has done so much to support our mission to get more and more people talking about their end-of-life wishes. We’ve helped make this a topic of national importance. We commend everyone who has taken this topic so seriously. 

Happy holidays and thank you to all who have done so much to spread the word, including sharing questions from The One Slide below:

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Holiday Coping With Grief: Bereavement Support After a Loved One Dies (Hospice Video 2:27)

Some people dread the holidays. They view them as slices of life that bring painful reminders of losing a loved one. They associate holiday traditions with familiar people and places that are incomplete and no longer fulfilling. These bereavement suggestions offer support for those coping with grief during the holidays:

Excerpt from “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

"Mourners have to decide the best ways they can adjust to the holidays. One option is to create new holiday traditions. If holidays were celebrated as a family, new traditions can be planned as a family, so everyone can have input. This will give family members an opportunity to discuss their feelings about the deceased loved one and possibly include something in the new tradition that commemorates that person in an uplifting manner. This could be a type of memorial that adds pleasure to holidays in the future, something that would have pleased the deceased.

Whether celebrating the holidays alone, with others, or not at all, people should always follow their hearts and do what feels best for them. There is no one way for everyone. There are different ways that work well for different people. Some people who found the holidays stressful, phony, or too commercial before their loved one died may want to redirect their holiday focus. They might choose to participate in an activity that is calmer and more meaningful to them such as volunteering at places where they can help others or sharing with others in another capacity. Others may want to celebrate alone or with a few friends, take a trip to another state or country, or just be involved with something they enjoy doing that may or may not have anything to do with the holidays, but everything to do with their own quality of life."

In this Hospice of the Florida Suncoast video titled “Hospice Care and Grief Counseling: Coping With Holidays After a Loved One's Death,” Sandi Sunter shares more suggestions for coping with holiday grief.

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Christmas and New Year: Death Risk Factors

Back in late August, I noticed a store clerk setting up Halloween decorations. After I commented that Halloween was really coming soon, the clerk casually mentioned that the Christmas decorations were already up on the other side of the shelf. In the sales world, that’s called getting customers in the holiday spirit early, so they’ll spend more money. Decorations may start them thinking about holiday foods, parties, trips, gifts, and death. Did I say death? That’s probably the last thing most people connect with the holidays.

Should people be thinking about holiday deaths, too? Research from the University of California confirms that they should. Using official U.S. death certificates in various hospitals around Christmas and New Year, researchers examined daily mortality rates. Results indicate that mortality from natural causes is highest in dead-on-arrival (DOA) and emergency department (ED) settings on Christmas and New Year. There are more DOA/ED deaths on 12/25, 12/26, and 1/1 than on any other days for each of the top five disease groups. Yes, Christmas and New Year are risk factors for deaths.

Although the research article didn’t explain precautions people should take that might keep them or their loved ones from being part of holiday death statistics, earlier research reported at “WebMD Health News” presented these recommendations from Dr. Alice Jacobs, president of the American Heart Association:

1) Don't skip regular appointments because of the holidays. Reschedule if needed.

2) Stick to your healthy habits through the holidays, and help your family do the same.

3) Be sure you have enough of your usual medications.

4) Check out the medical facilities where you'll be traveling.

5) Ask your doctor to recommend someone you could see if you need a doctor away from home.

6) If you have symptoms, don't ignore them.

It’s not too early to plan ahead for holiday death risk factors. Have safe and happy holidays!

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
“Hospice and Nursing Homes Blog”

Older Adults Make Safe Sex Video (2:22)

You know what’s frightening? Nearly one-third of all people living with HIV/AIDS are aged 50 and older. According to the Centers for Disease Control, 115,000 of the 475,000 people living with HIV/AIDS in the United States are 50+. That’s nearly double the number in 2001. The real numbers are likely higher because many people with HIV/AIDS remain undiagnosed.

Undiagnosed and infected people are estimated to cause two-thirds of infections.  Because many senior women are postmenopausal, they may not use condoms with the vigilance they would for preventing pregnancy. More sexual experimentation among seniors, including some increased by drugs like Viagra, also promote the likelihood of unprotected sex. 

You know what’s great? More seniors and others are paying attention to these statistics. They are understanding that rising rates of HIV/AIDS in their population require diligently using condoms, no sharing of needles, testing for HIV, and discussing HIV/AIDS with their doctors and others. They can make good use of resources available such as the National Institute on Aging.

But so much more can and should be done to get the message out about safe sex for seniors. Like any change, people can begin wherever they are to become part of the solution.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Hospice and Nursing Homes Blog